The management of colloid cyst remains controversial, evaluation of the competing methods seems to be necessary. We report on our experience with colloid cysts in the last decade: ten were managed solely endoscopically, 10 were resected microsurgically (9 via a transcortical/transventricular, 1 via a transcallosal approach). The outcome in the endoscopic group was excellent in 9 cases and unsatisfying in 1 case (recurrence). In the microsurgical group we achieved a good outcome in 5 of 10 cases, a fair outcome in 4 cases and 1 lethal outcome (caused by pulmonary embolism). Complications in the endoscopic group: one intraoperative bleeding, 1 stitch granuloma, 1 mispuncture of the ventricle, and 1 meningitis. Complications in the microsurgical group: 1 subdural effusion, 1 flap infection, 1 mild hemiparesis, 1 transient impairment of consciousness and 1 pulmonary embolism.
Mean operative time and length of hospitalization of the endoscopic group were clearly shorter than in the microsurgical group: 91 min versus 267 min time of surgery, 5.1 days versus 18.9 days of hospitalization. Complete resection was achieved in 8 of 10 cases of microsurgery, and in 3 of 10 cases in endoscopy. Endoscopic management results in lower costs and superior patients' comfort. The reduced number of total resections in the endoscopic group may lead to a higher recurrence rate in long-term follow-up, which might be a serious disadvantage of endoscopy. However, more experience in the endoscopic techniques may result in a higher rate of total resection of colloid cysts.
2
Hernesniemi J, Leivo S.
Management outcome in third ventricular colloid cysts in a defined population. A series of 40 patients treated mainly by transcallosal microsurgery.
Surg Neurol.
1996;
45
2-14
5
Lewis A I, Crone K R, Taha J, van Loveren H R, Yeh H S, Tew Jr J M.
Surgical resection of third ventricle colloid cysts. Preliminary results comparing transcallosal microsurgery with endoscopy.
J Neurosurg.
1994;
81
174-178
10
Camacho A, Abernathey C D, Kelly P J, Laws Jr E R.
Colloid cysts: experience with the management of 84 cases since the introduction of computed tomography.
Neurosurgery.
1989;
24
693-700
12
Mathiesen T, Grane P, Lindquist L, v Holst H.
High recurrence rate following aspiration of colloid cysts in the third ventricle.
J Neurosurg.
1993;
78
748-752
13
Abernathy C D, Davis D H, Kelly P J.
Treatment of colloid cysts of the third ventricle by stereotactic microsurgical laser craniotomy.
J Neurosurg.
1989;
70
525-529
16
Deinsberger W, Böker D K, Samii M.
Flexible endoscopes in treatment of colloid cysts of the third ventricle.
Minim Invasive Neurosurg.
1994;
37
12-16
17
Decq P, Le Guerinel C, Brugières P, Djindjian M, Silva D, Kéravel Y, Melon E, Nguyen J P.
Endoscopic management of colloid cysts.
Neurosurg.
1998;
42
1288-1296
18
Gökalp H Z, Yuceer N, Arasil E, Erdogan A, Dincer C, Baskaya M.
Colloid cysts of the third ventricle. Evaluation of 28 cases of colloid cyst of the third ventricle operated on by transcortical transventricular (25 cases) and transcallosal/transventricular (3 cases) approaches.
Acta Neurochir.
1996;
138
45-49
21
Kondziolka D, Lunsford L D.
Stereotactic techniques for colloid cysts: roles of aspiration, endoscopy, and microsurgery.
Acta Neurochir Suppl.
1994;
61
76-78
